Massive fines considered for new doctors

BANGKOK: New doctors could be fined millions of baht from next year if they fail to undergo a mandatory three-year internship upon graduating from a state-run university – which is subsidised by the government – according to the Public Health Ministry.

Interns at work at a Bangkok hospital. Graduates who skip the mandatory three-year internship will soon face high fines by the Public Health Ministry. Photo: via Bangkok Post

A government group met last Wednesday (June 25) and suggested the fine be raised more than tenfold to B5 million. The group is studying how much the education of a doctor costs in Thailand from 2018 until next year.

The penalty now stands at B400,000 but Public Health Minister Piyasakol Sakolsatayadorn suggested in recent comments this has become an anachronism given that it was put in place over two decades ago.

He noted that inflationary pressure made it equivalent in today’s terms to about B4mn.

Medical studies are costly even at state-run universities, which is why newly graduated doctors are essentially given the chance to either redeem some of the costs by paying a fine or work at a state-run medical facility for three years after collecting their diploma.

Dr Piyasakol said the proposed fine of millions of baht was a rough estimate but that it would definitely be increased in reflection of young doctors’ growing salaries, adding the ministry and schools must talk more.

Costs also vary according to the quality of the medical school and the level of technology at its disposal, the minister said.

He conceded that some graduates choose to pay the fine so they can work at a privately run hospital, which can prove much more lucrative.

The health minister stressed that graduates can choose to pay the fine or do the internship. He said that of the 3,000 new doctors who graduate each year in Thailand, 80% remain in the civil service in the early years after they graduate.

Dr Ittaporn Kanacharoen, deputy secretary-general of the Medical Council, said he understood that some graduates would prefer to pay the fine because many of those who land jobs at the Public Health Ministry are sent to work in remote parts of the country.

“Some might feel disheartened at having to work far from home. They can find it difficult to adjust,” he said.

After completing their internship some doctors seek transfers to universities or other agencies including the police or military, which provide them with scholarships to study in specialised medical fields.

“Some of them run into financial problems, so they decided to jump to a private medical facility [after serving out their internship] in order to save some money to pursue their studies overseas,” said Dr Ittaporn.

He said hiking the fine would only help slow the brain drain as doctors would still be free to leave the country within a few years of graduating.

He said they mostly want a stable and secure career path, adding that ways should be sought to provide them with specialised training overseas and the desire to return afterwards to work in Thailand.

Meanwhile, King Mongkut’s Institute of Technology University Ladkrabang said in March that it has established a faculty of medicine to help the nation keep up with its demand for doctors as it becomes an ageing society.

The faculty accepted its first batch of 50 students that month. It’s six-year bachelor’s program will be taught completely in English.